| Eastlake Modern Dentistry Dental Group | |
|
1690 Millenia Ave Ste 102 Chula Vista CA 91915-2889 | |
| (619) 348-5324 | |
| Not Available |
| Full Name | Eastlake Modern Dentistry Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 1690 Millenia Ave Ste 102, Chula Vista, California |
| Authorized Official Name and Position | Emiliano Navejas Carpio (DDS/OWNER) |
| Authorized Official Contact | 6193485324 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastlake Modern Dentistry Dental Group Po Box 920050 Dallas TX 75392-0050 Ph: (714) 845-8890 | Eastlake Modern Dentistry Dental Group 1690 Millenia Ave Ste 102 Chula Vista CA 91915-2889 Ph: (619) 348-5324 |
| NPI Number | 1043774854 |
|---|---|
| Provider Enumeration Date | 01/25/2019 |
| Last Update Date | 02/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043774854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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